Friday, 26 August 2011

Head and Neck Pain (Part Five)

Hello. To all of you who suffer from joint pain, I am feeling for you today. The weather has been so damp and horrid that joints must be suffering more than normal; we need some sun based heat to ease our bones!

This is the penultimate blog in the series of muscle based head and neck pain and I am looking at those people who have tried many forms of therapy to help pain before they see me.

I see a lot of people coming into my treatment room as if seeing me is the last resort; they have tried everything, even aura massage (I kid you not!). Their head and neck pain is personal, intense, tiring and persistent and they want it to go away. However nothing has worked for them and the headaches, migraines and neck tension come back every other day, every week or every month. The most common pattern is that they have been told after having scans, x-rays, Consultants looking at there headaches and neck restrictions that they should have physiotherapy as it is soft tissue based pain. The physiotherapy has tried to strengthen and stretch the muscles and hasn't had too much effect and then my clients are told to have a massage. They book into their local salon for a relaxation treatment and they either walk out feeling no effect, or sadly, worse. Maybe after that they try other forms of holistic therapy, but nothing really 'gets in there and sorts it out'.

So let's look at each step in that process to see what we can see.

Scans, X-Rays and Consultants: I am over the moon when clients have had the tests and seen the medical experts before they see me! In fact, I encourage people to go through this process, although it is lengthy and painful at times, when they start seeing me if they haven't already. Why? Well, that's simple, I can't diagnose anything. That isn't my training and although I love seeing MRI scans, I haven't been trained to read them and so I don't know what I am looking at as far as using it as a diagnostic tool. So as soon as a Consultant or G.P says that the pain is based in the muscles being too tight (contracted), or weak (elongated), that is where I step in. As my clients regularly hear me tell them: 'Get a picture!'

Physiotherapy: Many people berate Physiotherapy in the U.K. Sadly, many people have seen a Physiotherapist through the NHS and those highly trained and talented therapists just aren't given enough time or money to complete their jobs in the way that they could if they where given a little more freedom.
Personally I fail to understand why Massage and Physiotherapy aren't recommended as a dual approach to beating muscle based pain. The focus of Advanced Clinical Massage is to treat trigger points, stretch muscles gently, regain the over all health of the connective tissue and muscle fibre and get people to a place where they can then progress to safe and effective exercise. Physiotherapy takes over at that point and helps people regain range of motion; increasing the fitness of the muscles and connective tissues. Working hand in hand, Advanced Clinical Massage and Physiotherapy would work wonders as they compliment each other beautifully. The same can be said for the combination of Advanced Clinical Massage with Osteopathic, Chiropractic, and Acupuncture care; working holistically with each other should mean that people suffering with pain get out of it quicker.

In short, there is no reason to just see one person; if you can get a combination of people who can help your body with their different skill sets you will get a much more rounded result.

Salon Based Massage: I have been a salon therapist; it is where I learned my trade! I spent three and a half years doing Swedish Massage on 6 people a day. I got a lot of people under my hands in a very safe and supportive setting. I was privileged enough to be part of a great team and my boss really encouraged me to leave and find my own way in the big wide world of therapy. I know what it's like to give, and to receive, a massage in a salon. (In fact I had a nice massage yesterday at the salon up the road).

I think that where people get confused is partly due to the focus of a salon. Salons are designed to lull you to sleep and they do it really well. (I was away with the fairies yesterday!). They are warm, relaxing and smell divine. They are there for you to get away from the bustle of the world around you and I really value them for that. But the massage is not focused on beating your muscle based pain pathways. The therapists are trained to a good Level 3 or 4 (4 is the equivalent to an A-Level), and then they stop. The anatomy is good, but not in depth, and I would argue that if they are focused in on relaxing people it doesn't need to be any more than that.

Getting focused on anatomy, pathologies, injuries, techniques and basically some incredibly nerdy stuff takes a minimum of another 4 years of practice and training, so to find the level above a Salon based Swedish Massage is rare, but at least you know that when you have found that person you are seeing someone who is truly dedicated to getting rid of your headaches. They will probably read anatomy books over their tea breaks and take bodywork journals to read in bed before they go to sleep. Believe me, I know!

The focus in my treatments is different and although I would hope you go away feeling relaxed, or maybe even energized, I ask you to move around a lot, I ask for you to communicate on how we are doing, what you are feeling and at what level as well as incorporating range of motion tests, orthopaedic evaluations and the like. It's not a salon experience as I even give you homework!

So take heart, I may be the last resort but there is always a way forward. Obviously there are loads of treatments that I haven't mentioned today, but I think those are the 3 stories that I am guaranteed to hear on a daily basis. I would love to hear your experiences and if you would like me to blog on any others, do let me know and I'll do my best to write about it!

What I'm loving in the Treatment Room today: I have taken this week off from treatments and have been doing the tax accounts, reading around my dissertation subject as well as sewing some cushion covers for the living room! Today I am taking the afternoon to cut out a trouser pattern and watch series 9 of Spooks; the rain had put me off doing a Pilates class!

Music of the day: Some very far out West-Coast hippie Americana; I love it!

Wednesday, 17 August 2011

Head and Neck Pain (Part Four)

Hello! It's great to know that you are reading this blog and I hope that you find it helpful. If you have just joined me, I am writing a series during the summer about how Advanced Clinical Massage Therapy may help when people suffer from muscular based head and neck pain including headaches, tinnitus, jaw pain, shoulder discomfort and radiating pain patterns.  

If you haven't clicked on to it already, I would really advise that you read the blog entitled 'Pain Patterns Explained', which was posted on July 6th. It will give you a very clear out line of where these thoughts, ideas and techniques come from.

As the last post explained I am now writing about how I approach carrying out treatments for people who present pain in three typical ways. No one will fall in to the three categories completely as you are all uniquely you! However I feel that they will give you a good introduction to who I work.

The first group I would like to look at today are those who are cautious of receiving massage therapy for pain.

Pain is personal. There is no other way to look at it. Everyone is in pain through events that have happened in their lives and as no one else has lived these events like you have, they are thus totally one offs. True, many people have fallen off a bike, however only I have fallen off my bike in the way I did after the day that I had and in the circumstance that I was in. Therefore the neck pain I get from where and how (both emotionally and physically) I hit my head on the pavement is unique to me. This is why I believe everyone has to be treated solely on their own terms.

The main problem I see is that people are cautious of receiving massage therapy for pain because their own personal history has never been considered. They have been treated for a bike accident, but never for their bike accident. They are naturally cautious of their pain being belittled and seen as 'only a bit of minor soft tissue bruising', which is a phrase I sadly hear all too often. I always keep in mind that the people I see are their own enteritis, which is why I very rarely treat partners on the same day as I believe that you all need personal space to ease into the treatments that you have received.

(If David and I had therapy on the same day and both wanted to talk about it over dinner in the evening, we would both feel miffed that the other was just itching to talk about theirs and not listening properly to the other one!!)

The other reason why some people feel cautious about receiving massage for pain in England is that as a therapy it has only ever been seen as a relaxation aid, or it is seen as 'Sports Therapy' and most people equate this technique with causing pain.

When you are in pain all you want is for it to go away. You don't want to feel relaxed and you certainly don't want to feel more pain. So why has massage only offered the two things that you don't want?!

The training in England is getting a lot better and the research behind how massage works is now at a very high scientific level so we are now able to re-train in Advanced Clinical Massage Therapy (ACMT). ACMT is a mixture of Myo-Fascial Release, Massage, Trigger Point Work, Stretching, the use of hot and cool modulates as well as teaching you how to help yourself at home, and a lot more besides!

Although I use a lot more than the above, they form the back bone of all the treatments that I carry out. I believe that this fully holistic approach offers you a way of relaxing the muscles that are often short, tight and full of trigger points that cause your head and neck pain. The also strengthen the muscles that are long and weak and can't hold your posture in a correct manner. My aim is to see you walking out of my treatment room with less pain than when you walked in with, but I don't have to cause more pain for that to happen.

I treat heads and necks a lot whilst you are lying on your side, which for many clients is a new experience. The reason why I do this is so I can treat the Sternoclydomasoid (SCM), Scalene group, and Traepzius muscles in deep and effective way. I can also get to the base of your head (the sub-occipital muscles), with out having to turn your head to the side. As all your head muscles turn, flex and extend your head, if I can treat them in a neutral state, the massage becomes more effective.

I also include neck stretches into the treatments. Some people are worried about stretching and moving a neck when they hurt and when the muscles are tight. However I feel it is the best time to get them to elongate and release. I only ever work with you and only take you to the point where you feel the stretch begin to kick in, never beyond that point. I tend to use an active stretch where I stretch your muscles for you, as well as a resisted stretch, which is when you resist the stretch with about 10-20% of your natural resistance. These work quickly and effectively and I like to work with the Sub-Occipitals, Levator Scapluar, Trapezius, SCM and Scalene group during these stretches as these are the main culprits for head and neck pain.

Many people who are worried about receiving massage for head and neck pain get stuck in their movements and over the years I have come to call this state as 'Lock Down'. You will go home with homework from Cornerstone Therapies and 9 times out of 10 it will to beat the 'Lock Down' that you find yourself in. We need to get you moving, so we do this slowly, consistently and with out loosing the personalized focus for your particular pain history.

The next post will be looking at problems that may arise when people have seen many different therapists before they come to see me for their pain problems and not had any results.

I hope you found today's post helpful and if you have any problems/questions/comments or thoughts, do let me know and I'll do my best to respond!

What I'm loving out of the Treatment Room today!:
Green and Black's Milk Chocolate with Almonds.... the main reason for my headache today, but oh so yummy!

Music of the day:
I'm seeing my best friend tonight and we are seeing 'Super 8' at the flicks, but when ever I see her I am reminded of Laura Marling.

Tuesday, 16 August 2011

Head and Neck Pain (Part Three)

Hello all! I hope that this summer season has treated you all well. Whether you have been away enjoying the big wide world, or if you have been seriously thinking of turning the heating up during August here in England, (I confess I have succumbed), I hope you are feeling relaxed and happy.

Over the past month I have been writing about head and neck pain as it is a complaint that I see on a daily basis at Cornerstone Therapies. After looking at some typical 'Pain Patterns' over the past two blogs, I thought I could just sit down and write about how I treat them. However it hasn't been that easy and it has made me really think about how I approach my work with each client. For all of you who read this and see me at Cornerstone Therapies, I would like to thank you for pulling me up short in this area as I have had my eyes freshly opened once again to the fact that therapy can't, and never should, be a cookie cutter process.

Last week I treated 8 clients who have head and neck pain, which was exactly half the number of clients I treated, (I treat 16 clients a week). Looking back at my notes I can safely say that they all received a totally different treatment from each other. What did surprise me is that when looking back on that one week, the techniques I used for them where based on how they presented their pain emotionally as well as physically.

With this in mind I thought I would break down my approach to how I treat head and neck pain into 3 sections for you to read about. Although no one will fall directly into these camps as each person is uniquely different, I hope it will be a good introduction to the way that I work.

I will be writing about treatment plans based on head and neck pain for:
  • People who are cautious of receiving massage therapy for pain.
  • People who have tried many forms of therapy to help pain before they see me.
  • People who really want massage to work for them but are not sure what I do!

I am already writing these posts so I will hopefully get them all up in the next couple of weeks for you to read instead of having massive gaps between them as I have done over the past month, (mainly due to being really busy at home).

Just a quick note to let you all know that although Cornerstone Therapies is closed for treatments next week (August 22nd - 30th) I am around. I am just taking that week to sort out the data collection sessions I need to do for my dissertation. So if you would like to email or call me to book your treatments, please feel free.

What I'm loving in the Treatment Room today:
I have to thank my Mum, (who was a massage therapist for 20 years) for this little trick of the trade. A lot of people (no matter who old they are) have thin skin. MyoFascial Release Techniques (MFR) can be quite painful if the skin is dragged or crushed too much, so Mum suggested that I use Talc as I can't use oil for MFR. I have been using Neal's Yard Baby Powder, which is a blend of Corn Starch and Propolis (a natural immune booster found in bees wax). It has been great in the treatment room and I will be using it from now on.

Music of the day:
The Ipod is on charge as I write this, but the CD player is spinning 'Tired Pony' at this moment. Joy. 

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